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Minnesota's health insurance exchange debuts Tuesday

Babe the blue ox watches over a Friday MNsure board meeting. Babe is a MNsure mascot (Forum News Service photo by Don Davis)

ST. PAUL -- Minnesotans may begin shopping for insurance online Tuesday, as a fundamental part of a new federal health law begins.

A majority of people receive health insurance via their employers and nearly all of those policies will continue as is. Those on government-subsidized health care, some small-business employees and people without insurance or who carry their own private insurance are the ones who may be attracted to government-run services known as “marketplaces” or “exchanges.”

MNsure is the Minnesota marketplace. It is a politically divisive program subject to extensive debate in the state Capitol, debate that continued as opening day neared.

Marketplaces such as MNsure are the foundation of federal health-care reform, popularly known as Obamacare.

Basically, a health-care marketplace gives people a way to compare and buy health policies on line, although the work also can be done via telephone or in person. The bulk of MNsure clients will be those who under current law would receive free or inexpensive coverage from federally funded Medical Assistance and state-subsidized MinnesotaCare.

Just 300,000 individuals not part of a government program are expected to buy policies through MNsure in the next two years. Some of them, if their income is low enough, will get federal help to reduce their premiums.

In the first couple of years, 1.3 million Minnesotans are expected to use the program. An estimated 150,000 Minnesotans are expected to get insurance their small-business employers buy through MNsure, with some companies eligible for reduced premiums.

Another 700,000 are projected to be Medical Assistance clients and 180,000 will come from MinnesotaCare.

As MNsure inched toward its launch, news reports have been peppered with controversy: a dust-up over using Paul Bunyan and Babe the Blue Ox as bumbling mascots, the agency not providing grants so minority communities could learn more about MNsure and an employee (now an ex-employee) emailing private information such as Social Security numbers of insurance brokers to an insurance agent.

Starting what amounts to a major business in a few months (the law establishing MNsure passed in March) has been a major undertaking, but agency officials say they expect the launch to go on as planned Tuesday.

There are warnings that Minnesotans should not expect perfection.

“This may not all work, and it is not because people are not working hard,” said MNsure board member Tom Forsythe, urging agency staffers to be open about potential problems. “Transparency is our friend. ... We would be better served if we had been telling everybody these things.”

Another board member, Human Services Commissioner Lucinda Jesson, agreed that there could be glitches. “We need to be realistic about expectations and celebrate the steps of progress.”

She added that “The staff are working nearly around the clock to get a secure enrollment system up and running.”

MNsure Executive Director April Todd-Malmlov said the project is so complex that it always has been considered to be at “red status,” meaning there are lots of places where things can go wrong.

Jennifer Dupuis of Esko pointed to one of the issues she has encountered. As someone who is supposed to help fellow members of the Fond du Lac Band of Lake Superior Chippewa navigate MNsure, she told board members that it is difficult to determine whether someone officially is an Indian, which affects their insurance.

Some Minnesota tribes have asked MNsure questions “and have not had very clear answers,” she said, encouraging MNsure to reach out to Indians via media and other methods.

Board member Phil Norrgard, Fond du Lac’s human services director, said MNsure “will just have to limp along” until it improves how it deals with Indians, who get extra benefits under the federal health-care law.

Todd-Malmlov said her team will closely monitor how things work during the marketplace’s opening days. She assured board members that the staff is ready to respond to any issues.

Minnesotans likely will not begin buying insurance in large numbers right after launch.

Todd-Malmlov said many will just window shop in October, seeing what they might want to buy later. “We really do think most of the account creating and actual purchasing will be happening in November and December.”

There is no hurry to buy, she said, because policies cannot start until Jan. 1.

Forsythe suggested that Minnesotans would be better served to hold off on visiting www.mnsure.org until after its staff has time to work out any bugs.

Thousands of Minnesotans are undergoing training, or just finished, to help with MNsure. They include county workers who register the poor for government health programs as well as people who will help potentials insurance-buyers navigate the system.

Also being trained are insurance brokers and agents, an integrated part of the system since MNsure will sell policies provided by private companies.

Don Davis has been the Forum Communications Minnesota Capitol Bureau chief since 2001, covering state government and politics for two dozen newspapers in the state. Don also blogs at Capital Chatter on Areavoices.